Active NPI
Richard James Harrison
- Pharmacist
- O Fallon, IL
National Provider Identifier
1639288376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- Practice address
- 312 E State St
O Fallon, IL 62269-1425 - Phone
- (618) 624-5137
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 029712 | MO | |
| Pharmacist | 183500000X | IL | Primary |
Addresses
Primary practice location
312 E State St
O Fallon, IL 62269-1425
Mailing address
312 E State St
O Fallon, IL 62269-1425
Phone (618) 624-5137
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051031616 | IL | MD | Pharmacist |
| 029712 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639288376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 E STATE ST",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691425",
"telephone_number": "618-624-5137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 E STATE ST",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691425",
"telephone_number": "618-624-5137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "RICHARD",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "029712",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.